There’s a sad situation rumbling around the psychiatric and neurological worlds this week.

The Chairman of the Department of Psychiatry at Emory University in Atlanta is reported to be stepping down as Editor of the prestigious journal Neuropsychopharmacology, after failing to disclose that he had a financial interest in a treatment about which he had written approvingly.

The editor says that this was simply a clerical error, as on the previous occasion in 2003 when he published an article in which there was a conflict of interest.

This is all a great shame: the treatment that he talked about in this paper - vagal nerve stimulation - really does appear to be a genuine advance in the management of treatment resistant depression.

It is also eminently avoidable. Anybody who is an expert in their field will likely be asked to consult to a wide range of bodies. I have advised many pharmaceutical companies, governments and non-governmental agencies around the globe. Whenever I lecture, wherever it is in the world and whatever the subject, I always show a slide with a list of all the people with whom I have worked, and my office constantly updates the list, so that it can be appended to every document that we send out. And because I consult so widely, I don’t hold stock in any pharmaceutical or medical devices companies.

But here is another piece of failed disclosure. There is a comment to the report at the Scientist. The writer says that “Psychiatry has the greatest conflict of interest possible–they are prescribing drugs and, in this case, mechanical "treatments" for conditions that have no verifiable physical cause.”

This is absolutely and totally untrue. There are mountains of data confirming the physical component of most major psychiatric illnesses. And every day, all over the world, people in their tens of thousands are saved and their lives restored by pharmacological treatments used together with psychological and social help.

This is the same nonsense promulgated earlier this year by Tom Cruise. It reminds me of the critics of Galileo who refused to look through his telescope.

The writer herself fails to disclose that she is also involved in Scientology.

One of the major reasons for the failure of relationships or of businesses is a failure to communicate clearly. There are also powerful reasons for thinking that much ill health is rooted in “blockages:” inadequate communication between your body, your mind, your emotions, subtle systems and spirituality.

Any communication consists of ten essential components:

1. The integrity and mental state of the sender
2. The intent of the sender
3. The expectation of the sender
4. The information
5. The medium
6. The context
7. The receiver
8. The mental state of the receiver
9. The reaction or response of the receiver
10. The meta-text and meta-communication of the exchange

Naturally, in a healthy communication, everyone involved takes turns being the sender and the receiver, and this interaction between you creates the overall message. I must be very clear that I’m not just talking about verbal communication, but also physical and intimate interactions, business and family discourses.

I’d also like to take the whole notion of communication a step further: meaningful communication needs for us to be consciously aware of the interaction, and we should see it not just as an exchange of information, but of energy. A charismatic individual may communicate a lot more than mere words and his or her impact may last long after the words have been forgotten. On the other hand, there is actually a technical term – phatic communion - for empty language that is purely used for social lubrication: “How are you?” “You’re welcome,” “Have a nice day.”

It really is important to be aware of all of these components of communication. A problem in any one of them can make a mess of any attempt for people to connect. Too often I see people think only of the sender, the message and the recipient, without realizing that it is the other aspects of communication that are the keys to success or failure. This is often very important in therapy: people may ruminate on something said to them, when they should be considering the context of whatever was said.

Meta-text and meta-communication refer to the whole spectrum of other components of our interactions that stretch beyond the message itself. These include the types of language that we use as well as prosodic cues. And if people are in close proximity, body language and gesture. You may well know that it is possible to tell a great deal about someone’s intentions by studying changes in the tone of their facial muscles, changes in the color of their skin and the directions I which they move their eyes when speaking. How we use certain words to fill in our communication can be as important as the main body of a communication. Something that we do all the time is to try to understand the underlying meaning or meta-text, that is often quite different form the actual words being spoken.

Whether dealing with an individual in therapy or a business that wants to perform better, there is a series of critical questions that will uncover communication problems:

1. Do you have any communication problems?
2. Who is responsible for it?
3. Is there a disconnection between the mental state of any message sender and the message itself?
4. Does the sender have a clear purpose in communicating?
5. Are people able to understand the sender? (T.E. Lawrence (of Arabia fame) was said to have one of the largest vocabularies at the University of Oxford. So large that many people didn’t have a clue what he was talking about!)
6. Is information being communicated appropriately?
7. Is the environment conducive to communication?
8. What is interfering with communication?
9. How long has this been a problem?
10. Why has the problem not been solved?

If there is a communication problem, consider starting from scratch:

1. Any communication contains information and energy: are they both clear and pure?
2. Is there congruence between what is being communicated and the intent of the communicator?
3. Is there a culture of integrity in communications?
4. Are people striving for the greater good or personal aggrandizement?
5. What people, policies or procedures are interfering with communication?
6. How are communications becoming degraded?
7. What and who’s emotions are interfering with the informatyion and the energy of any communications?
8. What might lead to the misunderstanding of a message?
9. What systems are in place to ensure that communications are being received and understood correctly?
10. What system of questioning is in place?

Once we understand each of the phases of communication, and that it is a dynamic exchange of energy and not just information transfer. And that ANY message or communication is subject to degradation, and that there are ways to check for and correct it, you are well on your way to abolishing many of the problems that can wreck relationships, capsize companies and ruin a therapeutic alliance.

“Once a human being has arrived on this earth, communication is the largest single factor determining what kinds of relationships he makes with others and what happens to him in the world about him.”
– Virginia Satir (American Family Therapist, 1916-1988)

“Skill in the art of communication is crucial to a leader’s success. He can accomplish nothing unless he can communicate effectively.”
– Norman Allen (American Playwright, Recipient of a Charles MacArthur Award for Outstanding New Play)

“A world community can exist only with world communication, which means something more than extensive shortwave facilities scattered about the globe. It means common understanding, a common tradition, common ideas, and common ideals.”
–Robert M. Hutchins (American Educator, and, from 1929-1945, President of the University of Chicago, 1899-1977)

During a visit to Singapore a couple of years ago, I heard about some interesting research that’s just been published in the American Journal of Epidemiology.

The authors did something fairly simple. They took a group of 1,010 people with no evidence of dementia aged 60-93 years, and correlated their consumption of curry with their cognitive performance. Studies like this are not easy: what if more intelligent people like eating curry to begin with? What if sick people can’t get out to the local curry house? And so on.

But the researchers did this all very carefully: they took into account all the known sociodemographic, health, and behavioral determinants of performance on a simple cognitive test. So they controlled for many of the other factors that can accelerate cognitive decline, like depression, smoking, drinking alcohol, high blood pressure, glucose and lipids.

The result was that people who occasionally or often ate curry had significantly better cognitive function than people who "never, or rarely" ate curry.

Is there any logic to this?

Well in fact there is. Curcumin, from the curry spice, turmeric, has been shown to possess potent antioxidant and antiinflammatory properties and to reduce beta-amyloid and plaque burden in experimental studies. There have been serious suggestions about using active constituents of tumeric to try and prevent the development of Alzheimer’s disease.

This research is all very encouraging. The amount of curcumin used in the experimental studies is similar to the amount ingested by having a couple of curries a week, and now the epidemiological study from Singapore suggest that those couple of curries may have a clinically measurable effect.  That’s not to say that eating curry three times a day is going to be even better.

All things in moderation: too much curry can play havoc with your digestive processes.

And your relationships….

You may well have heard the advice that we all need to keep the bacetria in our intestines healthy. Countless experts have recommended that, as long as we are not lactorse intolerant, we should regularly take some live yoghurt to "re-colonize" our intestines with nice friendly bacteria.

There has just been a briefing in London to warn the public that as many as half of the "probiotic" or "friendly bacteria" products on sale in the United Kingdom could be ineffective and some may even be harmful.

The experts on the panel included Professor Glen Gibson from the University of Reading who is an expert in food microbiology, and recommended sticking to products made by major manufacturers. Too many of the other productsmight not contain the numbers of bacteria advertised, and the icrobes might not survive long enough in the intestines to do much good.

The evidence that probiotics help is still far from settled, as discussed in a recent review. But there are enough reports to think that probiotics may be helpful for irritable bowel syndrome and perhaps inflammatory bowel disease.

An even newer area or interest in the use of "prebiotics:"  short-chain carbohydrates that alter the composition, or metabolism, of the intestinal organisms in a beneficial way.

Make sure that if you are using a product, it comes from a reputable manufacturer, and that it contains at least 10 million bacteria. And as I said in my title, "Caveat Emptor," "Let the buyer beware."

The symptoms of Parkinson’s disease have been reported throughout history, but it was first described in the modern era by the great Scottish neurologist James Parkinson in 1817. Even after all these years, we still do not know all that much about what causes it. There’s an interesting study in the August issue of the journal Neurology, which is the official publication of the American Academy of Neurology.

Investigators from the Mayo Clinic used what is known as a case-control design (196 cases and 196 matched controls). What they found was that people who suffered from hay fever or allergic rhinitis, are 2.9 times more likely to develop Parkinson’s disease over a 20-year period.

The researchers did not find any association with autoimmune illnesses such as lupus, rheumatoid arthritis, pernicious anemia or vitiligo. They also did not find any association with asthma.

In addition, people who developed Parkinson’s disease used anti-inflammatory agents less frequently than controls, although this result was not statistically significant. The results may support the hypothesis that there is an inflammatory component in the causation of Parkinson’s disease.

You may ask, “Why on earth would anyone even look at a link like this?” The answer is that there have been previous reports of an association between the use of non-steroidal anti-inflammatories and lower rates of Parkinson’s disease in men but not in women and Alzheimer’s diseases.

This study does not suggest that hay fever causes Parkinson’s disease: it provides evidence for an association between the two. Parkinson’s is probably a group of illnesses with different causes. However, if chronic inflammation around the upper airways could produce inflammation in the brain, we might have a whole new way of preventing a degenerative brain disease.

In a future posting I’ll talk about some natural methods for reducing the burden of inflammation in your body.